17C-231 (2) 2 Northampton
Department
Memorandum
To: Tony Patillo r
From: Duane Nichols V
Date: December 12, 2005
CC: Brain Duggan
Re: 34 North Maple St. AMR Ambulance
Secondary to a review of the plans submitted to me for review, I concur with the
issuance of a building permit subject to the following conditions:
• Keys with engraved key tags are required to be placed in Fire Department
Emergency Key Box
• Graphic Map by fire (alarm control panel is changed to reflect build out of area
• Hom/Strobes are required in vehicle storage area and offices. Strobes are
required in bathrooms
• Double action pull stations are required at exits
• 5 lb ABC fire extinguishers are required. These shall be located at exits.
•Page 1
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R ti (riff Of �,To fljarllpfolt
Q l E �i casaCE(ntrlla' _.
a DEPARTMENT OP BUILDING INSPECTIONS _
212 Main Street " Municipal Building
Northampton, Afass. 010GO
WOR.ICER'S CO'iN[PENSA`MN LNSURANCE All
(l cctuxl(�crrni tics>:
v 6 ___y (rhonc-) 1, y /
(su�.t/ci tylszai.c.�a p)
do hereby certify, under the pains and penalties of pcgw-y., 1 at
O I am an employer providing the following ��,orkcr's comoenszDo1 coverage for 111)
eml)[ovees wor�xi g on this job`
(Lnsuran=CoQD.1-- ,),) (Potic:NLL-bcr) (r':'proton D;n-)
( ) I am a sole proprietor, general contractor or homeowner(ci c;e one) and have hired
the contractors listed below who have the follo�yui g worker's coOjtnsation policies:
t Namc of Con=ctor) (Inn!rancz Comma iyiPo ie; Dale)
- (Name of Concamor) -- (l.nsl-anc: Comoaay/Polim `unto) (—BPir Lion Date)
OName of Coon-actor) Qnsuraac: Com /Poll Numtu) (Exair doo Date)
I
(Name of Contractor) (Losuranc-- Comrany/Poliey Numb:r) - (Expimdon Dale).
(aaa ah�64jY:OC1I e,,,iraoo .7 to cscu4�=iaf0fm 00 pctaiaw6 w
i
I am a sole proprietor and have no one working for me.
( ) I am.a home owner perforrnitig all the,work myself.
NOTE:plc:-%c be evil o—`+trite 6ocncowacn�ibo cmploy pcmoas to tli r--;•.•,-+3= c=—zcu o e rcpau work as a d..cU_Z of
ant more the Lb oe=r J ra W hMb the bomoo+wer rr d) or oa[be p oUnDC�zppurte tb_�eT oo(C t1y o rs;d=vd to be
employes antic the..al ct10��* -+ton Act(GU 5E]_.n t rppticzboa by a bomeowva fra c 6czr _or pumit r=y C,46 c the
legal rt331r of ea exployx under tt-Wor'eora Cocapoonat-on Act
t ua6--rid tba a oopy of tbi.mt.e =�y bo fo,ardod to tbo Dopnrtmmt of ladaatriel Acod.,Ay Oflioe of Ira—for th.
eovcrxat vu-ireftioa=A dun L-i)u=to steam tovcre�e u�rl�t somioa 2 S A of MG 151 c=Iesd to the'v�rsnsGioa of ci ainst pcatttir=
C—isinxg of•ftDc orup to S 1-500.00■rtdlor oCup to ooc year Lod asil pm..f:ia in tsc Corm or.Stop Woric Ordc r"rid.
f=oC S t 00.00
For dcq.rtm=�uX only
Pcrm)t NLLmbcr
Lot
V S' LU, C ctf C�1LSGCIiC 177E[t GC e I
Version 1.7 Commercial Building Permit May 15,2000
r
SECTIONt,10=5TRUCTt7RAL:PEEi2 REVIEW(Z$0 CM1?01 t=
p nn Structural
Iride endent Structural Engineering g Peer Review Required Yes No
SECTION.11 OWNER A RIZATION TO-BE-,,COMPLETED WHEN.
OWNERS AGENT;OR CONTRACTOR APPLIES FORBUILDIR[GPERMIT
I ,
R, L as Owner of the subject property
i I #
hereby authorize' �e to
act on my behalf,in all matters relative to work authorized by this building permit application.
U
Signature of Owner Da
as Owner/Authorized
Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief.
Signed under the pains and penalties of periur rte.
Print Name
Signature of Owner/Agent f Dat
-SECTfON.12-xGONSTRUCTIOTI SERVICES -
10.1 Licensed Construction Supervisor• Not Applicable 0
I
Name of license Holder:F
License Number
AIN
Address Expiration Date
fe
Signature C
Telephone
SECTI 1 0 ERS'COMPENSAtION.INSURANCE AFFIDAVI f;(M GL'.c '[52;;§;25C(ti)j
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the bui ' g permit.
Signed Affidavit Attached Yes No 0
r
Version 1.7 Commercial Building Permit May 15,2000
SECTION 9-PROFESSIONAL DESIGN AND GONSTRUC7•tQL SE MCES FOR BU I[.DiNGS*L E" EgVp
CONSTRUCTION CONTROL PU12StJANT TQ_780 CMR 11.6(CONTAINING MORE THAN35;000 C F.OF Owl*ED PACE)
9.1 Registered Architect:
Not Applicable ❑
� 3
4 I
Name(Registrant):
Registration Number
Address
Expiration Date
Signature Telephone
9.2 Registered Professional Engineer(s):
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
i
Address Registration Number
� 1
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone I Expiration Date
3 General Contractor
Not Applicable ❑
Company Name:
i
Responsible In Charge of Construction
r �
Address
Signature Telephone
f V
Versionl.7 Commercial Building Permit May 15,2000
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage '
Setbacks Front
Side L` ' R:= L:= R:= !
Rear -
SuiTding 171eignt I i i
Bldg.Square Footage
i
Open Space Footage �_ %
(Lot area minus bldg,&paved
parking)
#of Parking Spaces
Fill:
volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO Q DONT KNOW Q YES Q
IF YES, date issued: 1
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW Q YES Q
IF YES: enter Book Page; and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , Date Issued:
C. Do any signs exist on the property? YES 0 NO Q
IF YES, describe size, type and location: ! i
D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO 0
IF YES, describe size, type and location: j 1
E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES NO Q
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Versionl.7 Commercial Building.Permit May 15,2000
r _
SEETION 4 C:ONSTRUCT,10 sSERVICES.F-6, �PRb,J50-TT ESS THAN 35 OOo- .
t _
CUBIC FEET'QEENCLOSED51xACE
Interior Alterations ❑ Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑
Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other❑
Brief Description Enter a brief description here.
Of Proposed Work:
I
SECTIONS-USE GROUP ANQ CON$TRU 'EIOIYPE .
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly A,1 ❑ A-2 ❑ A-3 ❑ 1A ❑
A-4 ❑ A-5 ❑ 1 B ❑
B Business ❑ 2A ❑
E Educational ❑ 2B ( ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑ 3A ❑
1 Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑
M Mercantile ❑ 4 ❑
R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑
S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑
U Utility ❑ Specify:
M Mixed Use Specify: j
S Special Use 0 Specify-
COMPLETE THIS SECTCOI%IF F CISTI�t BU1LQ[NGll DE12GQ1RGG'RElttOafATIOkIS, [ID BONS tF3fORCEfAN'GE-1t�t:USE
Existing Use Group: 1 Proposed Use Group: '
Existing Hazard Index 780 CMR 34):1 Proposed Hazard Index 780 CMR 34):
SECTION'S'BUILDINGEiEIGGiFANQ lF2EA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION
i
Floor Area per Floor(sf)
1 5l w p v Ca
2nd s
2nd i
3rd I
3`d
3
4d'
4th
Total Area(sf) Total Proposed New Construction s
Total Height(ft)
Total Height ft I
7.Water Supply(M.G.L.c.40,5 54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System:
Public ❑ Private ❑ Zone Outside Flood Zone❑ Municipal ❑ On site disposal system❑
w
Versionl.7 Commercial Building Permit May 15,2000
City of Northampton
Building Department
212 Main:Si:reet
Room'100
Northampton, MA 01060
phone 413-587-1240 Fax 413-587-1272 „
APPLICATION TO CONSTRUCT,REPAIR,RENOVATE,CHAN61 7�14E U'iE 6R C6_ NCY OF OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWOTAMTLY DWELLING
s>`ciOK sITErN%oRMaTror� w DEC 7 'C
� rtis oct ta6emprefect office_ s
_----'H-Prooerty-Address•
t � j �*
� t
l G[[ ��feFE3rnC
SEGZ70N 2. PROPERTY OINNERSF�rPfAC1THORL�EDvAGEIVfi
2.1 Owner of Record:
yy++ i
7�J AhA i
Name(Print) Current Mailing Address:
S11-'U"7'7
/Signature �-- Telephone
2.2 Authorized Anent:
Name(Print) Current Mailing Address:
I
Signature .d Telephone M
SECTlON,3--ESTIMQTED,CONSTRUCTION'-COSTS
Item Estimated Ccst(Dollars)to be '' Q,fcial Use.O_nEy;
completed by ermit applicant
1. Building Ca}Bwldmg,Permit Fee
2. Electrical �, (b)Estimated Total Cost of.
Construction from ,6 ' +���O -)
3. Plumbing ,
g � � O p u 1 4,5dildin"d,Permtt"Fee:
4. Mechanical(HVAC) I_ i
i4
5.Fire Protection
6. Total=0 +2+3+4+5) Check Number
_. . . : .....This-Section Foc OfficiahlTse Only
n _
=B ulldirg�PerFaift�rrlber Qafe
Issued`
r
Signature
Building Commissionernrispecfor of Bdildings .Date
File#BP-2004-0722
APPLICANT/CONTACT PERSON JEFFREY GUIEL
A ADDRESS/PHONE 187 POWELL RD CUMMINGTON (413)634-0182
PROPERTY LOCATION 34 NORTH MAPLE ST
MAP 17C PARCEL 231 001 ZONE SI
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: INTERIOR RENOVATION DIVIDING WALLS BATH RENO&ADD BATHROOMS
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 029501
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF ATION PRESENTED:
Approved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
Major Project: Site Plan AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Come
C
Signature o ui ding Official Date
Note:Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health,Conservation Commission,Department
of public works and other applicable pernut granting authorities.
*Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of
Planning&Development for more information.
34 NORTH MAPLE ST BP-2004-0722
GIs#: COMMONWEALTH OF MASSACHUSETTS
MU:Block: 17C-231 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2004-0722
Project# JS-2004-1048
Est. Cost: $130000.00
Fee: $650.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: 3B Contractor: License:
Use Group: F2 JEFFREY GUIEL 029501
Lot size(sq.ft.): 59241.60 Owner: LHIC INC
Zoning: SI Applicant: JEFFREY GUIEL
AT. 34 NORTH MAPLE ST
Applicant Address: Phone: Insurance:
187 POWELL RD (413) 634-0182
CUMMINGTONMA01026 ISSUED ON:112312004 0:00:00
TO PERFORM THE FOLLOWING WORK.-INTERIOR RENOVATION DIVIDING WALLS,
BATH RENO & ADD BATHROOMS AMENDED 12/15/05
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 1/23/2004 0:00:00 $650.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
CCit of Xorrt4ttmiTtan
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipai Building
Northampton, MA 01060
I\�PEC'TOR
Jeffery Guiel
187 Powell Road
Cummington, MA 01026
March 3, 2008
Dear Jeff,
Building permit number BP-2004-0722, issued on January 23, 2004 and amended December 8,
2005 for interior renovations at 34 North Maple Street is still open. Final inspections for a number of
electrical, plumbing and gas permits have not been completed, the final building inspection has not
been done and we have not yet received a letter of substantial completion from the architect of record. I
have included a list of the permits for this project indicating the status of each permit.
I visited the property on Thursday, February 28, 2008. It appears that the work covered by that
permit has been completed. Final inspections must be completed and the permit needs to be closed.
We will not issue additional permits involving that same building until that happens. The build out work
for AM B Care Ambulance Service in tenant space 17 cannot proceed at this time.
Please make arrangements to complete the required inspections and submit the architect's
letter of substantial completion as soon as possible. If you have any questions, please call. Our
telephone number is 587-1240 and our office hours are Monday through Friday, 8:30 am to 4:30 pm,
excepting that we close at 12:00 noon on Wednesdays. My email address is:
Iasbrouck(-)city northampton ma us.
Thank you for your cooperation in this matter.
Louis Hasbrouck
C�'`'`� -
City of Northampton
Local Inspector and Zoning Enforcement
Ihasbroucka-city northampton ma us
cc:
Robert Chapdelaine
AM B Care Ambulance Service
15 Sawin Street
Marlborough, MA 01752
Eric Suher
LHIC Incorporated
P.O. Box 771
Holyoke, MA 01041
CGU-4 of �'.art4an tan
DEPARTMENT OF BUILDING INSPECTIO:VS
212 Main Street . Municipal Building
Northampton, MA 01060 +v" 1~�
I\SPECTOR
Robert Chapdelaine
AM B Care Ambulance Service
15 Sawin Street
Marlborough, MA 01752
March 3, 2008
Dear Robert,
Thank you for meeting with me at 34 North Maple Street today and discussing your plans. A
building permit is necessary for the v✓ork being performed in tenant space 17. We will temporarily allow
a trailer in the existing space but you must obtain a building permit to complete the build-out. The
permit application must include proof that the special permit for that space was registered. Please
include a fire narrative along with your plans. We will also need plans showing that the exterior lighting
on that building complies with the applicable zoning ordinances (§350-12.2). 1 have included
information on the lighting requirements along with this letter.
There is also an existing permit in place for the tenant separation walls and toilets. That work
appears to be complete, but final inspections were not done. The work must be completed and
inspected before any additional permits are issued. I have notified the property owner and the
contractor. I am also sending them copies of this letter.
If you have any questions, please call. Our telephone number is 587-1240 and our office hours
are Monday through Friday, 8:30 am 1:o 4:30 pm, excepting that we close at 12:00 noon on
Wednesdays. My email address is: Ihasbrouck(cr-city.north ampton ma us.
Louis Hasbrouck
ity of Northampton
Local Inspector and Zoning Enforcement
Ihasbrouck(cDcity northampton ma us
cc:
Jeffery Guiel
187 Powell Road
Cummington, MA 01026
Eric Suher
LHIC Incorporated
P.O. Box 771
Holyoke, MA 01041
The Commonwealth of Massachusetts � Y .
City of Northampton ` TM
-
Temporary Certificate of Occupancy
In accordance with 780 CMR, Section 120.3 (The Sixth Edition of the Massachusetts State Building Code)
this Temporani,/ Certificate of Occupancy is issued to the premise or structure or part thereof as herein identified.
Identify Name of Bnildhig of Space Within Certificate No.
Issued to AM B Care Ambulance Service BP-2004-0722
Identify property address including street number, name, city or town acid county Certificate
Located at Expiration
34 North Maple Street Tenant Unit #17 April 30, 2008
Northampton, Hampshire, Massachusetts
Use Group Allowable
Classifications) S-1 Moderate Hazard Storage Occupant Loads
To be determined
7h1S Te111p01"al'y Ce1'tlf care of Occupancil is hereby Issued by the undersitylled to certtf"�l. 4 st.
b_.�_. y u1at the Yicuuse,stt ucture or portion thereof as herein specified has been
inspected for general fire and life safety features. This certificate shall allow for the temporary use as herein described and in conformance with any and all conditions
as identified below. It shall be posted in a conspicuous place within the space as directed by the undersigned. Failure to post the certificate,failure to comply with
conditions or,tampering with the contents of the certificate is strictly prohibited.
Conditions of Temporary (30 Day) Certificate of Occupancy, allowing the ambulance service to work out of an office trailer parked
Temporary Use inside tenant space #17, using the core bathrooms. Any non-compliant exterior lighting must remain off (350-12.2)
Name of Municipal Date of Map/Plot
Buildin Official Louis Hasbrouck Inspection 03/03/08
Signature of Municipal , / Date of
Building Official �� hJ l/Z.�� Issuance 03/28/08 �I ` '.